Men can get breast cancer, too

Breast cancer is mainly a disease for women, however less than 1 percent of breast cases occur in men.

There has been a slight increase in incidence of male breast cancer in the past decades without any improvement on the overall survival, unlike their female counterparts. The same advances in diagnosis and treatment of breast cancer that have been made in women are applied to men with breast cancer.

Due to the limited number of men developing breast cancer, long-term data is lacking. The majority of male breast tissue is centrally located, meaning about 85 percent of male breast cancers are found in the central portion of the breast by a physical examination.

Breast cancer screening for the general male population is periodic self-breast examination and annual physical examination. There is a lack of clinical data to date to support screening mammogram for men. However, in those men with a strong family history of breast cancer, BRCA1/BRCA2 mutation or personal history of breast cancer, a mammogram is likely indicated.

What causes breast cancer in men?

The underlying cause for male breast cancer can be attributed to a number of factors. The most common denominator is an imbalance of androgens and estrogen. Gynecomastia, a benign enlargement of both or one breast in men, is not a risk factor for developing breast cancer. However, risk factors for gynecomastia and male breast cancer are similar including history of chest radiation, mumps orchitis, and bilateral cryptorchidism.

Certain genetic predisposed conditions increase the risk of breast cancer in men, including but not limited to BRCA2, Klinefelters, and Cowden’s syndrome. All male breast cancers should be referred to a genetic councilor. Liver disease, pituitary tumors, medications which may disturb the balance between androgens and estrogens may increase the risk of developing male breast cancer. Environmental factors such as electromagnetic field exposure may increase the risk of developing male breast cancer; however studies have been inconclusive to date. A history of radiation exposure is a risk factor for developing male breast cancer.

What are the symptoms of breast cancer in men?

Male breast cancer may present in the following:

Nipple discharge

Ulceration, bleeding

Skin inversion

Swelling

Breast pain

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The symptoms may be present for several months before a man presents to his health care provider, therefore historically men presented at a more advanced stage. Recently published series indicate an increase in public awareness and men are presented sooner at a lower stage.

Majority of male breast cancers are invasive ductal carcinoma, where the cancer has started in the ducts leading to the nipple. Male breast cancer treatment is essentially the same as the treatment of breast cancer in women including surgery, possible radiation, systemic chemotherapy and/or anti-estrogen oral therapy.

The risk of another breast cancer in male survivors is less than female survivors. Breast cancer prevention in majority of men can be achieved by maintaining an ideal body weight, and restricted alcohol consumption. Early detection by frequent self-breast examination, annual physical examination, and visiting a health care provider soon with breast related complaints will improve survival and treatment options.